title: Effect of time and day of admission on 1-month survival and neurologically favourable 1-month survival in out-of-hospital cardiopulmonary arrest patients.
abstract: OBJECTIVE
  We sought to examine whether the outcomes of out-of-hospital cardiopulmonary arrest (OHCA) patients differed between weekday and weekend/holiday admissions, or between daytime and nighttime admissions.
  
  
  METHODS
  From a national registry of OHCA events in Japan between 2005 and 2008, 173,137 cases where the call-to-hospital admission interval was shorter than 120 min and collapse was witnessed by a bystander were included in this study. One-month survival rate and neurologically favourable 1-month survival rate were used as outcome measures. Logistic regression was used to adjust for potential confounding factors.
  
  
  RESULTS
  No significant differences in outcome were found between weekday and holiday/weekend admissions in rates of 1-month survival or neurologically favourable 1-month survival (p=0.78 and p=0.80, respectively). In contrast, patients admitted in the daytime exhibited significantly better outcomes than those admitted at night, on both outcome measures (p<0.001 and p<0.001). After adjusting for possible confounding factors, outcomes were significantly better for daytime admissions, with odds ratios of 1.26 (95% confidence interval (CI) 1.22-1.31; p<0.001) for 1-month survival, and 1.26 (95% CI 1.20-1.32; p<0.001) for neurologically favourable 1-month survival. In contrast, no significant differences on either outcome measure were found between weekday and weekend/holiday cases, with odds ratios of 1.00 (95% CI 0.96-1.04; p=0.96) for 1-month survival and 0.99 (95% CI 0.94-1.04; p=0.78) for neurologically favourable 1-month survival.
  
  
  CONCLUSIONS
  Even after adjusting for confounding factors, admission day (weekday vs. weekend/holiday) had no effect on 1-month survival or neurologically favourable 1-month survival. In contrast, daytime admission was associated with significantly better outcomes than nighttime admissions.
authors.affiliation: Department of Planning, Information and Management, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo 113-8655, Japan. koikes@adm.h.u-tokyo.ac.jp
authors.forename: Soichi
authors.initials: S
authors.lastname: Koike
authors.forename: Seizan
authors.initials: S
authors.lastname: Tanabe
authors.forename: Toshio
authors.initials: T
authors.lastname: Ogawa
authors.forename: Manabu
authors.initials: M
authors.lastname: Akahane
authors.forename: Hideo
authors.initials: H
authors.lastname: Yasunaga
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Horiguchi
authors.forename: Shinya
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Imamura
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007564:Japan / Q000453:epidemiology; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D010343:Patient Admission / Q000592:standards*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors